Inpatient

Hospital discharge data received by public health agencies has a reporting lag time of greater than six months. This data is often used retrospectively to conduct surveillance to assess severity of illness and outcome, and for evaluating performance of public health surveillance systems. 

With the emergence of Health Information Exchanges and Regional Health Information Organizations (RHIOs), inpatient data can be available to public health in near real-time. However, there currently are no established public health practices or information systems for conducting routine surveillance in the inpatient setting. 

Through a contract with the Centers for Disease Control and Prevention, New York State Department of Health

initiated the development of a statewide public–health Health Information Exchanges with New York RHIOs. Daily

minimum biosurveillance data set data-exchange implementation, and evaluation efforts were focused on one RHIO (RHIO A) and one participating hospital system composed of five acute-care facilities.

Objective

The objective of this paper is to assess the potential utility of inpatient minimum biosurveillance data set data obtained from RHIOs for pneumonia and influenza surveillance.

Objective

So as to be able to detect nosocomial outbreaks at an early stage, we examine the construction of a syndromic surveillance system for inpatients who have fever, respiratory symptoms, diarrhea, vomiting or rash and evaluate its statistical properties.

MUse will make EHR data increasingly available for public health surveillance. For Stage 2, the Centers for Medicare & Medicaid Services (CMS) regulations will require hospitals and offer an option for eligible professionals to provide electronic syndromic surveillance data to public health. Together, these data can strengthen public health surveillance capabilities and population health outcomes (Figure 1). To facilitate the adoption and effective use of these data to advance population health, public health priorities and system capabilities must shape standards for data exchange. Input from all stakeholders is critical to ensure the feasibility, practicality, and, hence, adoption of any recommendations and data use guidelines.

Objective

To develop national Stage 2 Meaningful Use (MUse) recommendations for syndromic surveillance using hospital inpatient and ambulatory clinical care electronic health record (EHR) data

It is estimated that in the United States (US), unintentional non-fire related CO poisoning causes an average of 439 deaths annually, and in 2007 confirmed CO poisoning cases resulted in 21,304 ED visits and 2,302 hospitalizations (71 per million and 8 per million population, respectively)1 . Despite the significant risk of morbidity and mortality associated with CO poisoning, existing surveillance systems in the United States are limited. This study is the first to focus specifically on CO poisoning trends within the VHA population.

Objective

To describe characteristics of Veterans Health Administration (VHA) patients with ICD 9/10 CM inpatient discharge and/or emergency department (ED)/urgent care outpatient encounter codes for carbon monoxide (CO) poisoning.

The ICD-9 codes for acute respiratory illness (ARI) and pneumonia/influenza (P&I) are commonly used in ARI surveillance; however, few studies evaluate the accuracy of these codes or the importance of ICD-9 position. We reviewed ICD-9 codes reported among patients identified through severe acute respiratory infection (SARI) surveillance to compare medical record documentation with medical coding and evaluated ICD-9 codes assigned to patients with influenza detections. 

Firearm violence is an issue of public health concern leading to more than 30,000 deaths and 80,000 nonfatal injuries in the United States annually. To date, firearm-related studies among Veterans have focused primarily on suicide and attempted suicide. Herein, we examine firearm violence among VHA enrollees for all manners/ intents, including assault, unintentional, self-inflicted, undetermined and other firearm-related injury encounters in both the inpatient and outpatient settings.